Provider Demographics
NPI:1316819030
Name:REPP CALIFORNIA PAIN & RECOVERY CHIROPRACTIC CORP
Entity type:Organization
Organization Name:REPP CALIFORNIA PAIN & RECOVERY CHIROPRACTIC CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:KIRT
Authorized Official - Middle Name:W
Authorized Official - Last Name:REPP
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:281-831-6290
Mailing Address - Street 1:108 BARBADOS DR
Mailing Address - Street 2:
Mailing Address - City:PONTE VEDRA
Mailing Address - State:FL
Mailing Address - Zip Code:32081-1506
Mailing Address - Country:US
Mailing Address - Phone:281-831-6181
Mailing Address - Fax:832-442-3800
Practice Address - Street 1:530 PLAZA DR STE 110
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-4782
Practice Address - Country:US
Practice Address - Phone:281-831-6290
Practice Address - Fax:832-442-3800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-22
Last Update Date:2025-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty